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Dongru Du,1– 3,* Bi Ran,1– 3,* Dan Xu,1– 3 Lian Liu,1– 3 Xueru Hu,1– 3 Tingting Zeng,1– 3 Yongchun Shen,1– 3 Fengming Luo1– 4 1Department of Pulmonary and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, 610041, People’s Republic of China; 2State Key Laboratory of Respiratory Health and Multimorbidity, West China Hospital, Sichuan University, Chengdu, 610041, People’s Republic of China; 3Division of Pulmonary Diseases, State Key Laboratory of Biotherapy of China, West China Hospital, Sichuan University, Chengdu, 610041, People’s Republic of China; 4Laboratory of Pulmonary Immunology and Inflammation, Frontiers Science Center for Disease-Related Molecular Network, Sichuan University, Chengdu, 610200, People’s Republic of China*These authors contributed equally to this workCorrespondence: Yongchun Shen; Fengming Luo, Tel +86 28 8542 2350, Fax +86 28 8558 2944, Email shen_yongchun@126.com; fengmingluo@outlook.comBackground: Sex steroid hormones, including testosterone and estradiol, play significant roles in various aspects of pulmonary health and diseases. However, although there were a few studies trying to link sex hormones with COPD, their effect remained limited due to small sample size and insufficient causal results. This study aims to investigate the association between sex hormones and chronic obstructive pulmonary disease (COPD) based on the National Health and Nutrition Examination Survey (NHANES) database and evaluate causality via a two-sample Mendelian randomization (MR).Methods: Data from NHANES 2013– 2016 were enrolled for the cross-sectional study. The association between sex hormones and COPD was evaluated via multivariable logistic regression. Sex-stratified analysis, subgroup analyses and interaction tests were performed to further evaluate the correlation. For MR analysis, data were collected from genome-wide association studies and FinnGen datasets. The inverse-variance-weighted (IVW) approach, along with four other approaches, was applied in the analysis. Further sensitivity analysis was conducted to assess the existence of pleiotropy and heterogeneity.Results: 7,617 eligible participants were enrolled in the cross-sectional analysis. Negative associations were observed in both testosterone-COPD (OR 0.770, 95% CI 0.626, 0.948, p = 0.018) and estradiol-COPD (OR 0.794, 95% CI 0.688, 0.915, p = 0.005) relationships after covariate adjustments. However, the results from IVW-MR analysis showed that no causal relationship was observed in either the testosterone-COPD (OR 0.83, 95% CI 0.53, 1.29, p = 0.407) or estradiol-COPD (OR 0.74, 95% CI 0.23, 2.38, p = 0.616) relationship, which was also supported by the other four approaches (all p values > 0.05).Conclusion: Although a significant negative association was observed between sex hormones and COPD, the results of MR analysis did not support the causality of this relationship. Our study suggested that sex hormones may indirectly rather than directly affect the development of COPD via potential covariates, which warranted further investigations.Keywords: sex steroid hormones, testosterone, estradiol, chronic obstructive pulmonary disease, NHANES, Mendelian randomization

Chuang Yang,1 Xing Feng,1,2 Junfeng Li,1 Yuchan Jiang,1 Huan Zhang,1 Yidan Gao,1 Jinxiang Tan,1 Bolin Ran3 1Department of Breast and Thyroid Surgery, the First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, People’s Republic of China; 2Department of Hepatobiliary, Breast and Thyroid Surgery, the People’s Hospital of Liangping District, Chongqing, 405200, People’s Republic of China; 3Department of Medical Laboratory Science, Laboratory of Traditional Chinese Medicine Hospital of Shizhu County, Chongqing, 409100, People’s Republic of ChinaCorrespondence: Jinxiang Tan; Bolin Ran, Tel/Fax +86-23-89011496, Email tjx1202@163.com; 729297969@qq.comPurpose: Medical students play an essential role in providing disease consultation for patients. Despite the rapid increase in thyroid disease, there are few data on how well Chinese medical students master the knowledge of thyroid diseases. This study aims to evaluate the clinical knowledge, perception, and clinical communication confidence of medical students on thyroid cancer (TC).Patients and Methods: This cross-sectional study was carried out among medical students of Chongqing Medical University. An anonymous, self-administered questionnaire distributed from December 2022 to February 2023 included items on demographics and other information, the warning signs of cancer, perception regarding a person’s chance of developing cancer, and clinical communication confidence. Descriptive analysis, difference analysis, and correlation analysis were carried out.Results: A total of 226 medical students participated in the survey. Most students (n=191, 84.5%) had heard of TC, while only a few (n=10, 4.4%) regularly performed thyroid self-examination. One hundred and eighty-four students (81.4%) agreed that an unexplained lump or swelling could be a sign of cancer. There were significant differences in thyroid clinical knowledge in relation to gender (P< 0.001), major (P=0.026), and thyroid disease (P=0.030). Clinical communication confidence showed significant differences in year of study (P=0.002), major (P=0.048), and graduate major (P< 0.001). There was a correlation between clinical confidence and year of study (r=0.261, P< 0.001).Conclusion: Most medical students have sufficient clinical knowledge on TC prevention, but there are still misconceptions related to TC screening. In addition, medical students lack confidence in communicating with patients. Comprehensive communication training should be integrated into the medical curriculum and clinical activities should be initiated earlier.Keywords: thyroid cancer, cancer warning signs, clinical communication confidence, communication skills training, medical students

IntroductionNonalcoholic fatty liver disease (NAFLD) is an epidemic in the obese population. Bariatric surgery is known to reverse multiple metabolic complications of obesity such as diabetes, dyslipidemia, and NAFLD, but the timing of liver changes has not been well described.Materials and methodsThis was an IRB-approved, two-institutional prospective study. Bariatric patients received MRIs at baseline and after a pre-operative liquid diet. Liver biopsies were performed during surgery and if NAFLD positive, the patients received MRIs at 1, 3, and 6 months. Liver volumes and proton-density fat fraction (PDFF) were calculated from offline MRI images. Primary outcomes were changes in weight, body mass index (BMI), percent excess weight loss (EWL%), liver volume, and PDFF. Resolution of steatosis, as defined as PDFF

Dan Ge,1,2,* Qiqi Du,1,2,* Bingqing Ran,1,2 Xingyu Liu,1,2 Xin Wang,1,2 Xuehu Ma,1 Fang Cheng,1,3 Bingbing Sun1,21State Key Laboratory of Fine Chemicals, Dalian University of Technology, Dalian 116024, People’s Republic of China; 2Department of Chemical Engineering, Dalian University of Technology, Dalian 116024, People’s Republic of China; 3Department of Pharmaceutical Science and Technology, Dalian University of Technology, Dalian 116024, People’s Republic of China*These authors contributed equally to this work Abstract: Engineered nanomaterials (ENMs) have been widely used in various fields due to their novel physicochemical properties. However, the use of ENMs has led to an increased exposure in humans, and the safety of ENMs has attracted much attention. It is universally acknowledged that ENMs could enter the human body via different routes, eg, inhalation, skin contact, and intravenous injection. Studies have proven that ENMs can cross or bypass the blood–brain barrier and then access the central nervous system and cause neurotoxicity. Until now, diverse in vivo and in vitro models have been developed to evaluate the neurotoxicity of ENMs, and oxidative stress, inflammation, DNA damage, and cell death have been identified as being involved. However, due to various physicochemical properties of ENMs and diverse study models in existing studies, it remains challenging to establish the structure-activity relationship of nanomaterials in neurotoxicity. In this paper, we aimed to review current studies on ENM-induced neurotoxicity, with an emphasis on the molecular and cellular mechanisms involved. We hope to provide a rational material design strategy for ENMs when they are applied in biomedical or other engineering applications.Keywords: engineered nanomaterials, neurotoxicity, oxidative stress, inflammation, DNA damage, cell death

OBJECTIVE: Animal studies and clinical trials demonstrated the effectiveness of a combination of transplanted bone marrow stromal cells (BMSC) and electroacupuncture (EA) treatment in improving neurological deficits. However, the ability of the BMSC-EA treatment to enhance brain repair processes or the neuronal plasticity of BMSC in ischemic stroke model is unclear. The purpose of this study was to investigate the neuroprotective effects and neuronal plasticity of BMSC transplantation combined with EA in ischemic stroke. MATERIALS AND METHODS: A male Sprague-Dawley (SD) rat middle cerebral artery occlusion (MCAO) model was used. Intracerebral transplantation of BMSC, transfected with lentiviral vectors expressing green fluorescent protein (GFP), was performed using a stereotactic apparatus after modeling. MCAO rats were treated with BMSC injection alone or in combination with EA. After the treatment, proliferation and migration of BMSC were observed in different groups by fluorescence microscopy. Quantitative real-time PCR (qRT-PCR), Western blotting, and immunohistochemistry were performed to examine changes in the levels of neuron-specific enolase (NSE) and nestin in the injured striatum. RESULTS: Epifluorescence microscopy revealed that most BMSC in the cerebrum were lysed; few transplanted BMSC survived, and some living cells migrated to areas around the lesion site. NSE was overexpressed in the striatum of MCAO rats, illustrating the neurological deficits caused by cerebral ischemia-reperfusion. The combination of BMSC transplantation and EA attenuated the expression of NSE, indicating nerve injury repair. Although the qRT-PCR results showed that BMSC-EA treatment elevated nestin RNA expression, less robust responses were observed in other tests. CONCLUSIONS: Our results show that the combination treatment significantly improved restoration of neurological deficits in the animal stroke model. However, further studies are required to see if EA could promote the rapid differentiation of BMSC into neural stem cells in the short term. [ABSTRACT FROM AUTHOR]

This article discusses the use of deep learning to differentiate between cytomegalovirus (CMV) infection and severe ulcerative colitis (UC) through endoscopic imaging. CMV reactivation is common in patients with severe UC, and early diagnosis is challenging due to the time it takes to obtain biopsy results. The study used 7 convolutional neural networks to classify CMV and severe UC based on a dataset of 86 cases. The best-performing network achieved an accuracy of 0.8267, demonstrating the potential of deep learning models for non-invasive diagnostics and timely treatment interventions. [Extracted from the article]

Organic-rich black shales from the Upper Yangtze Platform from the Upper Ordovician and lower Silurian are considered excellent source rocks and unconventional reservoirs of hydrocarbons in South China. This research combined geochemical analyses and detailed sedimentological observations to investigate the depositional controls on organic-matter abundance in the prolific black mudstone of the Wufeng Formation and Long-1 Member of the lower Silurian Longmaxi. Six primary lithofacies deposited at variable marine water depths and under different water column chemistries were identified from a ∼50 m-long profile based on microscopic observations of sediment texture and structure, and analyses of total organic carbon (TOC) content, major and trace-element abundances, and pyrite framboid size. Our results showed that TOC content is strongly correlated with terrigenous SiO2 content and the non-detrital components of V, U and Mo, suggesting that the accumulation of organic matter in the studied shale was controlled by terrigenous clast fluxes and anoxic water conditions. However, the weak covariance relationship between TOC content and productivity proxies, including P/Ti and Ba/Al, demonstrates that the accumulation of organic matter was not controlled by primary productivity. The three high-productivity lithofacies of the Wufeng Formation and Long-1 Member have low Co*Mn values, indicating active marine upwelling during sedimentary periods. The northern margin of the Upper Yangtze Platform was an open basin system influenced by the Kwangsian Orogeny and global sea-level changes, but oxygen-depleted bottom waters in the basin favoured the accumulation and preservation of sedimentary organic matter, resulting in the formation of organic-rich black shales. [ABSTRACT FROM AUTHOR]

The co-occurrence of hepatic cystic echinococcosis (CE) and alveolar echinococcosis (AE) is extremely rare. Here, we present the clinical manifestations and treatment outcomes of three cases with co-occurring CE and AE in the liver. Computed tomography (CT), magnetic resonance imaging and 18FFluorodeoxyglucose Positron Emission Tomography-CT were used for preoperative diagnosis. Specimens were taken intraoperatively and sent for pathological studies to confirm the coexistence of CE and AE by laminated membrane, daughter cysts or germinal layer and infiltration structure. Albendazole was prescribed after operation for 12 months. All patients were completely recovered and showed no recurrence at last follow-up. Therefore, surgical intervention and postoperative application of albendazole are recommended for patients with concurrence of hepatic AE and CE. [ABSTRACT FROM AUTHOR]